Brain Enhancement Training for Age-Related Cognitive Decline

(BETTER Aging Trial)

Not currently recruiting at 1 trial location

Overseen By Michelle Voss, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Posit Science Corporation

Disqualifiers: Dementia, Severe visual deficits, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 53

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a computer-based brain training program called PACR-CT (also known as Brain Enhancement Training) to determine its long-term effects on memory and thinking skills in older adults. The study will assess benefits five years after initial training and test whether a short booster session can enhance results. It suits individuals aged 70 or older who can use a computer and do not have dementia. As an unphased trial, participants can contribute to innovative research that may improve cognitive health in older adults.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this training program is safe?

Research shows that the PACR-CT training program poses low risk. It is generally easy to handle, with no serious side effects reported. Previous studies on similar brain training programs have shown improvements in thinking skills without major problems. These programs aim to boost brain function using safe, online exercises. Therefore, participants can feel confident about the safety of the PACR-CT program. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about PACR-CT because it offers a fresh approach to tackling age-related cognitive decline by using computerized plasticity-based adaptive cognitive training. Unlike traditional treatments that might rely on medication to improve cognitive functions, this method focuses on enhancing brain plasticity through interactive sessions. The training is designed to be adaptive, meaning it tailors the difficulty to each user's performance, potentially making it more effective and engaging. This non-invasive, drug-free approach could offer a promising alternative or complement to existing therapies, particularly for those seeking a more personalized and active form of cognitive enhancement.

What evidence suggests that this training program is effective for age-related cognitive decline?

Research shows that the PACR-CT program, which participants in this trial will receive, can help improve thinking skills in older adults. Studies have found that older people who engage in brain training activities experience improvements in certain mental abilities, particularly those with mild memory or thinking problems. Additionally, evidence indicates that some benefits can occur even without follow-up sessions. These findings suggest that PACR-CT may effectively enhance brain function with age. ^{2 4 6 7 8}

Who Is on the Research Team?

Hyun Kyu Lee, PhD

Principal Investigator

Posit Science Corporation

Are You a Good Fit for This Trial?

This trial is for people aged 70 or older who speak English fluently, can see and hear well enough to use a computer, and can control a mouse. They must not have dementia as shown by the MoCA test. Those with severe visual/hearing deficits, recent cognitive training, suicidal thoughts, certain medical conditions or implants that interfere with MRI cannot join.

Inclusion Criteria

Participant must not have evidence of dementia as indicated by the Montreal Cognitive Assessment (MoCA)

I am 70 years old or older.

I am fluent in English.

Exclusion Criteria

Participant with claustrophobia or any other contraindication to MRI scanning

Participant with recent participation of computer-delivered cognitive training within 2 years of consent

I cannot stay still for an MRI that lasts 1 hour.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 visit

1 visit (in-person)

Pre-training

Cognitive and functional assessments, MRI/fMRI, and blood draw for all participants

1 visit

1 visit (in-person)

Training

Participants undergo 10 weeks of computerized plasticity-based adaptive cognitive training

10 weeks

Up to 50 sessions, 5 sessions per week

Post-training

Cognitive and functional assessments and MRI/fMRI after training

1 visit

1 visit (in-person)

Follow-up

Participants are monitored for changes in life satisfaction, sleep, functional abilities, diet, and other outcomes

5 years

What Are the Treatments Tested in This Trial?

Interventions

• PACR-CT

Trial Overview The study tests a web-based brain training program (PACR-CT) on elders to see if it helps their cognition five years after initial training and examines the effects of an additional 10 weeks of booster training. The software poses no significant risk.

How Is the Trial Designed?

Group I: Experimental Treatment Experimental Treatment 1 Intervention

Computerized plasticity-based adaptive cognitive training requiring a total maximum of 50 treatment sessions, up to 5 sessions per week, 42 minutes per session.

Who Is Running the Clinical Trial?

Posit Science Corporation

Lead Sponsor

Trials

40

Recruited

4,400+

University of Iowa

Collaborator

Trials

486

Recruited

934,000+

The University of Texas at Dallas

Collaborator

Trials

71

Recruited

108,000+

Published Research Related to This Trial

In a study of 40 healthy elderly participants, MRI scans revealed that atrophy of the hippocampus and amygdala (HA) is linked to poorer memory performance, indicating a potential marker for cognitive decline.

Unlike HA atrophy, the presence of deep white matter lesions (DWML) and periventricular lesions (PVL) did not correlate with memory impairment, suggesting that HA atrophy may be a more specific indicator of cognitive issues in aging individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Magnetic resonance imaging correlates of memory impairment in the healthy elderly: association with medial temporal lobe atrophy but not white matter lesions. O'Brien, JT., Desmond, P., Ames, D., et al.[2006]

In a study of 18 patients with probable Alzheimer's dementia, significant cognitive decline was correlated with reductions in brain perfusion and cortical volume, highlighting the relationship between brain structure changes and cognitive function.

Patients showed annual rates of ventricular volume enlargement and cortical atrophy, with cognitive tests indicating declines in scores, while age-matched controls exhibited no cognitive changes, suggesting that these CT changes are specific to dementia progression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive declines correlate with decreased cortical volume and perfusion in dementia of Alzheimer type. Obara, K., Meyer, JS., Mortel, KF., et al.[2019]

Neuroimaging studies show that the oldest-old (85 years and older) exhibit greater brain atrophy and a higher burden of white matter lesions compared to younger elderly individuals, which are linked to dementia and cognitive impairment.

Despite a high amyloid burden in the oldest-old, it remains a significant predictor of cognitive decline, especially when combined with other neuroimaging indicators like atrophy and white matter lesions, emphasizing the need for more research in this age group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neuroimaging in the Oldest-Old: A Review of the Literature. Woodworth, DC., Scambray, KA., Corrada, MM., et al.[2021]

Nearly 50% of elderly individuals with mild cognitive impairment (MCI) develop Alzheimer's-type dementia (DAT) within 5 years, highlighting the importance of early detection.

Magnetization transfer ratio (MTR) measurements in gray matter were significantly lower in both MCI and DAT groups compared to healthy controls, suggesting that MTR could serve as a novel MRI biomarker for early diagnosis of Alzheimer's dementia, even before significant volumetric changes are observed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Magnetization transfer ratio in mild cognitive impairment and dementia of Alzheimer's type. Kabani, NJ., Sled, JG., Chertkow, H.[2006]

A study involving 299 individuals, including 73 normal older adults and 91 with mild Alzheimer's disease, found that white matter (WM) volume declines with age, particularly in specific brain regions associated with cognitive function.

The research revealed that Alzheimer's disease is linked to further reductions in WM volume, especially in areas like the parahippocampal and entorhinal regions, highlighting the potential role of WM degeneration in cognitive decline related to aging and Alzheimer's.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Regional white matter volume differences in nondemented aging and Alzheimer's disease. Salat, DH., Greve, DN., Pacheco, JL., et al.[2022]

Citations

1. clinicaltrials.gov clinicaltrials.gov/ct2/show/NCT05599490?lupd_s=11%2F05%2F2021

Brain Enhancement Training Towards Elders Resilience to ... This study aims to examine the longer-term benefits of a novel, neuroplasticity-based, computerized and web-deliverable training program (PACR-CT) five ...

2. trialx.com trialx.com/clinical-trials/listings/226340/brain-enhancement-training-towards-elders-resilience-to-aging-phase-iib/

Brain Enhancement Training Towards Elders Resilience to ... Overview. This study aims to examine the longer-term benefits of a novel, neuroplasticity-based, computerized and web-deliverable training program (PACR-CT) ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9173785/

Long-term studies in cognitive training for older adults The studies reported improvements in cognitive performance for some motor abilities, among older participants of CT with or without booster sessions, including ...

4. nature.com nature.com/articles/s41598-025-08322-6

Enhanced cognitive performance in older adults through ... While some studies report cognitive improvements in older adults from combining CT with tDCS, others have failed to observe significant effects.

5. sciencedirect.com sciencedirect.com/science/article/pii/S1041610224027133

Early intervention for cognitive decline Results: Studies in healthy older adults and those with mild cognitive impairment are largely positive and suggest that CT has the potential to improve ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05599490

Brain Enhancement Training Towards Elders Resilience to ... This study aims to examine the longer-term benefits of a novel, neuroplasticity-based, computerized and web-deliverable training program (PACR-CT) five ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04997226

Cognitive Enhancement in Healthy Elderly People The main objective of the proposed research is to explore the potential intervention based on non-invasive brain stimulation and cognitive training to improve ...

8. nia.nih.gov nia.nih.gov/health/brain-health/cognitive-health-and-older-adults

Cognitive Health and Older Adults | National Institute on Aging Cognitive training, which is designed to improve specific cognitive skills, appears to have benefits for maintaining cognitive health in ...